Reader,

The next letter in this chronological installment comes from another referral I shared through a local listserv. Once again, my message had been approved by the client, and it was shared within a community of vetted therapists, as the listserv owner describes it.

When sharing a referral I am clear, very clear, when a client:

1. needs and requests to work with a therapist of color,
2. would strongly prefer to work with a therapist of color but is open to other therapists who can provide non-performative cultural attunement, or
3. would like to work with a therapist of color, but it’s not a must because they are more interested in finding someone who specializes in the issues the client is experiencing or in a certain modality that has helped the client make progress.

These are different requests, and I don’t treat them as interchangeable. In this case, the client requested option “a”: they needed and requested to work with a therapist of color. And this was one of the responses I received:

What I want to point out here is the subtle, but not-so-subtle, boundary violation.

The message begins by acknowledging that the clinician is not a person of color. So far, so good, one might think.

The response then says, "If they're still interested," which could be interpreted as offering consent and leaving the choice up to the client.

But then it goes on to describe the clinician, their practice, the issues they work with, the populations they serve, their availability, and even their office arrangements… AT… LENGTH…

And I know that sometimes, in therapy circles, we make fun of the requests we make and the responses we get. For a hypothetical example, someone might request a therapist who accepts insurance ABC and works with issue 123, only to receive a response saying, "Hey, I don't take ABC insurance, but I can offer a superbill, and I don't work with issue 123, but I did take a training, so I think I can help." We laugh because we've probably seen some version of this happen. But the example I'm sharing here is not quite the same thing.

This isn't about a mismatch in insurance, availability, or clinical specialty. It's about a marginalized identity and a client's request for a particular kind of support. And, as I've said before, this isn't only about race. It could be any other minoritized identity that is relevant to someone's experience, sense of belonging, or ability to feel understood in a therapeutic relationship.

The boundary violation in this email is very clear because even though the clinician technically acknowledges the client's request and doesn't explicitly tell them they should change it, the rest of the response does something else: it redirects the conversation, extensively, toward the clinician's qualifications, experiences, and perceived suitability. Instead of simply recognizing that they don't meet the request and stepping back, they offer a lengthy explanation of why the client might want to consider them anyway.

What is more, the phrase "if they're still interested" might sound like it's giving the client a choice, but it also subtly puts the responsibility back on them (and me) to reconsider, evaluate this alternative, and potentially explain why they aren't interested. The clinician has made their case, and now I, as the first recipient, have to decide whether to engage with it… or not. And that is emotional labor.

That might not seem like a big deal to some. But think about what happens when someone is already navigating a system where their needs, identities, and experiences have often been dismissed, minimized, or treated as negotiable. They make a specific request for their healing, and instead of having that request respected, they receive a response that asks them, implicitly, to make room for someone who doesn't meet it. That's another demand being placed on the person seeking care or the clinician initiating the referral.

And I have a hard time understanding how someone can claim to be attuned to clients while not paying attention to what a client has actually communicated. If a clinician isn't willing to acknowledge a request for a particular identity and instead centers themselves, their experience, and their practice, how can I be sure they're actually listening? How can I trust that they'll recognize when a client's needs aren't up for negotiation, or when the most appropriate response is to step back rather than persuade?

I'm not saying that a therapist who doesn't share a client's identity cannot offer meaningful, culturally attuned care. That's an entirely different conversation. I'm saying that when a client has clearly expressed a need or preference, we need to respect that information rather than treating it as an obstacle to overcome. We don't get to decide that our training, our good intentions, our eclectic approach, or our experience with marginalized communities should be enough to override what someone has told us they need.

So here's what I'd like to ask you: When a client tells us what they need, how do we know that we are actually listening?

With liberatory care,

Silvana

​​Liberatory Letters | The Practice of Liberation | Decolonize Your Practice​

PS. This is one of the reasons I created Widen the Frame, my free email series introducing the 12 conditions of a healing ecosystem. Healing isn't shaped by clinical approaches or the therapeutic relationship alone. It's also shaped by identity, relationships, community, culture, and the political and systemic conditions surrounding us. Widen the Frame invites you to look beyond the individual and the therapy room and consider what else matters when we're thinking about care and healing. If you're curious about Healing Is An Ecosystem but aren't ready for the full field guide, this is a place to begin.

PPS. Healing Is An Ecosystem takes the idea of widening the frame much further. The field guide is for clinicians who are ready to look beyond the therapy room and consider the conditions surrounding a person’s healing: material circumstances, community, culture and ancestry, spirituality, relationships, the body, identity, creativity, ecology, politics and systems, and more. It asks you to consider not only what you can provide as a clinician, but what else might belong in someone's healing ecosystem. You can think of Widen the Frame as the doorway, and HIAE as the place where we spend more time exploring what we find once we walk through it.

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⬆️ Let's connect!